The Naxal, the Tribal, and the Doctor

The Naxal, the Tribal, and the Doctor

Anirudh Burman

Anirudh is a graduate in law from Harvard Law School (LL.M.). He
currently works with the Centre for Policy Research, Delhi. His
interests pertain to issues of regulatory governance, and the
functioning of government agencies in India.

Recent news reports state
that the Chhattisgarh government has asked International Committee of
the Red Cross (ICRC) to suspend its operations in the Bijapur district
where it had operated for the past two and a half years. ICRC had been
providing medical help to violence hit people in the tribal dominated
area. This order of suspension raises important questions about (a) the
duty and ability of the state to provide medical services to the tribal
population in that area, and (b) the willingness of the state to allow
medical services to affected people in an area affected by Maoist
violence.

Bastar district is a predominantly tribal area, with more than
two-thirds of the population belonging to the Scheduled Tribes category.
Ninety percent of the population is rural, more than 87% of the
population is employed only seasonally, and literacy levels are among
the lowest in Chhattisgarh. Two thirds of the Village Reports, or Jan
Rapats prepared by the villagers themselves (Jan Rapats are prepared by
all villages in Chhattisgarh, and reflect the needs and views of the
villagers) state that health facilities in these areas are very poor.

Most villages emphasise that the availability of
medicines, appointment of health personnel, improvement in the quality
of health care, Government aid, and the availability of clean drinking
water are areas that require attention.”

Though 6.25% of Chhattisgarh’s population is based in the Bastar
district, the area had 3 hospitals, no dispensaries, and 57 Primary
Health Care centres as of 2001. Forty percent of the population had no
access to toilet facilities, safe drinking water, and electricity as of
2001.

Bastar has also been in the news recently owing
to the naxal attack on Congress’ Parivartan Yatra convoy on May 25,
2013, during which senior Chhattisgarh Congress functionaries and
security personnel were killed.

ICRC first expressed its willingness to enter Naxal affected areas in
Chhattisgarh in 2008, and was welcomed by Chief Minister Raman Singh
(Sourced from here):

“Certainly, ICRC plays a vital role in mitigating the
sufferings of people in conflict zones across the globe. With the kind
of resources and expertise ICRC has at its command, its presence will
benefit the poor tribals of the region where a huge population is
suffering and hundreds of children have been orphaned in the conflict…”

Interestingly, he went on to say,

“We have no problem even if such organisations provide medical assistance to Naxalites injured in encounters with security forces…We
also do the same thing. Whenever Naxalites are injured, they are
hospitalised so that they can be punished by a court of law for their
crimes.”

Since 2010, ICRC has run a Primary Health Care centre, mobile
clinics, and a hand-pump rehabilitation programme to ensure safe
drinking water for the tribal population. According to another Times of
India story, international agencies have helped play a crucial role in providing essential health care facilities in the region:

“Last year, when a diarrhoea epidemic broke out in South
Bastar, killing nearly 100 people, Bijapur administration had enlisted
the support of MSF and UNICEF, apart from calling doctors from other
districts. But in Dantewada, in the absence of such an intervention, and
in the face of an acute shortage of doctors, a large unknown number of
people died without medical support.”

Then why the order of suspension?

The order of suspension has ostensibly been given by the district
administration because “…ICRC is yet to enter into a Memorandum of
Understanding with the state government” regarding its work in the
region. State government sources have said that since ICRC is an
international organization, it needs “certain clearances from the
centre” for carrying out its operations.

If ICRC has operated in Bastar since 2010, how was it able to
function without obtaining clearances from the central and state
governments for almost three years? How was it able to bring in medical
equipment, and (presumably) foreign personnel into a security sensitive
area, and operate without the required permissions for all this time?
Does the state and district administration seriously expect people to
believe that they allowed ICRC to work in a Naxal dominated area for
close to three years without the proper paperwork?

News reports indicate
that other reasons may also be at play here. In 2011, the police in
south Bastar and Dantewada had alleged that ICRC, along with MSF
(Doctors Without Borders) which had been operating there since before
ICRC started working there, was facilitating the treatment of Maoist
rebels. Two Maoist rebels who had been arrested claimed that they were
being treated by ICRC and MSF.

“These two organisations are deliberately going to Maoist camps and
spending weeks. The foreign doctors should know what they are doing. I
am from an enforcement agency and can’t welcome them having extra love
for Maoists, but not for people injured in Maoist brutalities.” – Senior
Superintendent of Police, Dantewada (Sourced from here)

According to him, people from the two organisations could be
prosecuted under the Chhattisgarh Special Public Security Act that
prohibits direct or indirect contact with Maoists.

The recent order of suspension, coming soon after the Maoist attack
on May 25 can then also be seen through the lens of an overzealous state
and district administration irked by the fact that ICRC is treating
Maoist rebels. If in fact this is the case, several questions beg to be
asked: What prevents doctors from treating Maoist rebels injured in
conflict, especially after the Chief Minister himself expressly stated
that he would be fine with such treatment? Does the duty of a doctor to
treat injured people depend on whether a person is suspected of being an
insurgent or terrorist? Does such treatment in itself make a doctor an
accomplice in the crimes the injured is suspected of having committed?
If yes, should lawyers representing suspected terrorists also be made
accomplices to crimes committed by their clients?

The central government has repeatedly touted its plan of combining
development with improving law and order as a solution to Naxalism in
these regions. ICRC is one of the most reputed health care agencies
operating in Bastar, an area with a clearly documented lack of health
care facilities. The administration at all levels clearly needs to
reconcile its twin goals of development and security enforcement in a
transparent, and rational way. Essential health care for tribals in a
conflict-ridden area, and the work of doctors cannot be left to the
alternating prioritization of security enforcement and development. This
is especially so when the Jan Rapats reveal how miserably the state has
failed in meeting the expectations of the local population.